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Single and Multiple Ascending Dose Study of CORT125236 in Healthy Participants

Phase 1
Completed
Conditions
Healthy
Interventions
Drug: Placebo matching CORT125236
Registration Number
NCT05003713
Lead Sponsor
Corcept Therapeutics
Brief Summary

This is a 3-part, first-in-human study of single ascending doses (SAD; Part 1) and multiple ascending doses (MAD; Part 2) of CORT125236 in healthy participants; Part 3 is optional, to investigate whether CORT125236 ameliorates the effects of prednisone on various pharmacodynamic (PD) endpoints. The 3 parts may not be conducted entirely sequentially provided that this is justified by the pharmacokinetic (PK) and safety data obtained from completed cohorts. The first MAD cohort will not start until data are available from at least 3 SAD levels to allow MAD administration to proceed. The decision on whether to start Part 3 can be made at any point after completion of 3 SAD levels, and will be based on achieving sufficiently high plasma CORT125236 exposure in Part 1 of the study.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
82
Inclusion Criteria
  • Body mass index 18.0 to 30.0 kg/m^2, inclusive
  • Body weight ≤102 kg
  • Willing to consume a high-fat breakfast, including pork
  • Adheres to the contraception requirements of the protocol
  • Additional criteria apply.
Exclusion Criteria
  • Received any investigational drug or device in a clinical research study within 90 days
  • Evidence of current severe acute respiratory syndrome (SARS-CoV-2) infection
  • History of any drug or alcohol abuse in the past 2 years; a confirmed positive drugs of abuse test result
  • Regular alcohol consumption; a confirmed positive alcohol breath test at screening
  • Current smoker; a confirmed positive breath carbon monoxide reading; current user of e-cigarettes and nicotine replacement products in the last 6 months
  • Female of childbearing potential, pregnant, or breastfeeding
  • Male participant with pregnant or lactating partners
  • Clinically significant abnormal clinical chemistry, hematology or urinalysis result
  • Positive for hepatitis B surface antigen (HBsAg), hepatitis C virus antibody (HCV Ab) or human immunodeficiency virus (HIV)
  • Active renal and/or hepatic disease
  • History of clinically significant cardiovascular, renal, hepatic, endocrine, metabolic, respiratory, gastrointestinal (GI), neurological or psychiatric disorder
  • Any form of cancer in the 5 years (exceptions apply)
  • History of adrenal insufficiency
  • Have a condition that could be aggravated by glucocorticoid antagonism
  • Donation or loss of greater than 400 mL of blood or plasma within the previous 3 months
  • Currently using glucocorticoids or have a history of systemic glucocorticoid use in the last 12 months or 3 months for inhaled products
  • Additional criteria apply.

Study & Design

Study Type
INTERVENTIONAL
Study Design
SEQUENTIAL
Arm && Interventions
GroupInterventionDescription
Part 1: SAD Cohorts A through F PlaceboPlacebo matching CORT125236Cohorts will receive a single dose of placebo matching CORT125236 lipid capsule formulation by mouth on Day 1. The dose regimen and prandial state will be the same as those for the cohort members receiving CORT125236.
Part 2: MAD Cohorts A through D PlaceboPlacebo matching CORT125236Cohorts will receive once- or twice-daily doses of placebo matching CORT125236 lipid capsule formulation by mouth for 14 days. The dose regimen and prandial state will be the same as those for the cohort members receiving CORT125236.
Part 3: Single Dose Pharmacodynamic EffectPrednisoneIn Period 1, participants will receive a single dose of prednisone 25 mg (20 mg + 5 mg) tablet by mouth on Day 1 in a fasted or fed state. After a 7-day washout, in Period 2, participants will receive a single dose of prednisone as in Period 1 plus a single dose of CORT125236 lipid capsule formulation by mouth on Day 1 in a fasted or fed state. The dose of CORT125236 and the prandial state will be determined after evaluation of safety and PK data from Part 1. Part 3 of the study is optional.
Part 3: Single Dose Pharmacodynamic EffectCORT125236In Period 1, participants will receive a single dose of prednisone 25 mg (20 mg + 5 mg) tablet by mouth on Day 1 in a fasted or fed state. After a 7-day washout, in Period 2, participants will receive a single dose of prednisone as in Period 1 plus a single dose of CORT125236 lipid capsule formulation by mouth on Day 1 in a fasted or fed state. The dose of CORT125236 and the prandial state will be determined after evaluation of safety and PK data from Part 1. Part 3 of the study is optional.
Part 1: SAD Cohorts A through F CORT125236CORT125236Cohorts will receive a single dose of CORT125236 lipid capsule formulation by mouth on Day 1 in a fasted or fed state. Cohort A will receive a 20-mg dose in a fasted state. Cohort B will receive a ≤3-fold increase in dose from Cohort A in a fasted state; the dose level and dose regimen (whether to split the dose) will be determined after evaluation of safety and PK data for Cohort A. Subsequent cohorts will receive a ≤3-fold increase in CORT125236 dose from the previous cohort in a fasted or fed state; the dose level, dose regimen, and prandial state will be determined after evaluation of safety and PK data from previous cohorts.
Part 2: MAD Cohorts A through D CORT125236CORT125236Cohorts will receive once- or twice-daily doses of CORT125236 lipid capsule formulation by mouth for 14 days. The anticipated exposure will not exceed the highest exposure considered safe and well-tolerated during Part 1. The dose level, dose schedule, and prandial state for each cohort will be determined after evaluation of safety and PK data from Part 1 and preceding Part 2 cohorts.
Primary Outcome Measures
NameTimeMethod
Number of Participants with One or More Adverse EventsPart 1 SAD Cohorts: up to Day 12; Part 2 MAD Cohorts: up to Day 25; Part 3 Cohort: up to Day 19
Secondary Outcome Measures
NameTimeMethod
Plasma Adrenocorticotropic Hormone (ACTH) ConcentrationBefore dosing on Days 1 and 14 (Part 2 MAD Cohorts)
Plasma Interleukin-1 Beta (IL-1β) Concentration following ex vivo LPS StimulationBefore dosing and 1, 2, and 4 hours after dosing (Part 3, Periods 1 and 2 PD Cohort)
Maximum Plasma Concentration (Cmax) of CORT125236Before dosing and at pre-specified time points up to Day 5 (Part 1 SAD Cohorts), or up to Day 18 (Part 2 MAD Cohorts)
Time of Cmax (Tmax) of Plasma CORT125236Before dosing and at pre-specified time points up to Day 5 (Part 1 SAD Cohorts), or up to Day 18 (Part 2 MAD Cohorts)
Apparent Elimination Half-life (t1/2) of Plasma CORT125236Before dosing and at pre-specified time points up to Day 5 (Part 1 SAD Cohorts), or up to Day 18 (Part 2 MAD Cohorts)
Serum Cortisol ConcentrationBefore dosing on Days 1 and 14 (Part 2 MAD Cohorts)
Area Under the Plasma Concentration-time Curve (AUC) of CORT125236Before dosing and at pre-specified time points up to Day 5 (Part 1 SAD Cohorts), or up to Day 18 (Part 2 MAD Cohorts)
Lymphocyte CountBefore dosing and at pre-specified time points up to 24 hours after dosing (Part 3, Period 1 and 2 PD Cohort)
Neutrophil CountBefore dosing and at pre-specified time points up to 24 hours after dosing (Part 3, Period 1 and 2 PD Cohort)
Plasma Glucose4 hours after dosing and immediately prior to a high-carbohydrate lunch, and approximately 2 hours after starting the lunch (Part 3, Period 1 and 2 PD Cohort)
Serum Insulin4 hours after dosing and immediately prior to a high-carbohydrate lunch, and approximately 2 hours after starting the lunch (Part 3, Period 1 and 2 PD Cohort)
Plasma Tumor Necrosis Factor Alpha (TNF-α) Concentration following ex vivo Lipopolysaccharide (LPS) StimulationBefore dosing and 1, 2, and 4 hours after dosing (Part 3, Periods 1 and 2 PD Cohort)
Eosinophil CountBefore dosing and at pre-specified time points up to 24 hours after dosing (Part 3, Periods 1 and 2 PD Cohort)
Serum Osteocalcin ConcentrationBefore dosing and at pre-specified time points up to 24 hours after dosing (Part 3, Period 1 and 2 PD Cohort)

Trial Locations

Locations (1)

Site 01

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Ruddington, Nottingham, United Kingdom

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